1. Early Weight Loss during Chemoradiotherapy Has a Detrimental Impact on Outcome in NSCLC
- Author
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Anne-Marie C. Dingemans, Karin J. C. Sanders, Ruud Houben, Lizza E.L. Hendriks, Annemie M. W. J. Schols, Esther G.C. Troost, Gerben Bootsma, Promovendi NTM, Pulmonologie, RS: NUTRIM - R3 - Chronic inflammatory disease and wasting, Promovendi ODB, MUMC+: MA Med Staf Spec Longziekten (9), Radiotherapie, RS: GROW - School for Oncology and Reproduction, RS: FHML non-thematic output, and RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy
- Subjects
Male ,0301 basic medicine ,Pulmonary and Respiratory Medicine ,Weight loss ,medicine.medical_specialty ,Lung Neoplasms ,Cachexia ,Survival ,medicine.medical_treatment ,Adenocarcinoma ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Non-small cell lung cancer ,Carcinoma, Non-Small-Cell Lung ,Internal medicine ,Esophagitis ,Humans ,Medicine ,Neoplasm Staging ,Retrospective Studies ,Chemotherapy ,Performance status ,business.industry ,Hazard ratio ,Chemoradiotherapy ,Middle Aged ,Prognosis ,medicine.disease ,Confidence interval ,Surgery ,Survival Rate ,Radiation therapy ,030104 developmental biology ,Oncology ,030220 oncology & carcinogenesis ,Carcinoma, Squamous Cell ,Carcinoma, Large Cell ,Female ,medicine.symptom ,business ,Follow-Up Studies - Abstract
Objectives The aim of this study was to assess the effect of early weight loss before the onset of radiation esophagitis on overall survival (OS) in patients with non–small cell lung cancer treated with concurrent chemoradiotherapy. Methods Characteristics (e.g., patient weight, radiation esophagitis score, sex, World Health Organization performance status, chemotherapy dose, nodal status, and gross tumor volume) of 151 patients who received concurrent chemoradiotherapy (in 2006–2013) were retrospectively correlated with OS. Early weight loss was defined as weight loss of more than 5% between the start and third week of radiotherapy in patients whose weight was stable before treatment initiation. Results In 17% of the patients early weight loss was observed. Median OS (95% confidence interval [CI]) was significantly shorter in the early weight loss group (OS = 13.0 months, 95% CI: 2.0–24.0) versus in the non–early weight loss group (OS = 23.0 months, 95% CI: 14.7–31.3) (hazard ratio [HR] = 1.8, 95% CI: 1.12–2.96, p = 0.017). On multivariate analysis sex (HR = 2.1, 95% CI: 1.33–3.29, p = 0.001), World Health Organization performance status (HR = 1.9, 95% CI: 1.20–2.97, p = 0.006), nodal status (HR = 2.9, 95% CI: 1.38–6.01, p = 0.005), and early weight loss (HR = 1.9, 95% CI: 1.10–3.19, p = 0.022) were associated with OS. Conclusions Early weight loss in patients with non–small cell lung cancer was found to be associated with worse prognosis. These data warrant further investigation into the efficacy of tailored intervention to prevent early weight loss.
- Published
- 2016